Top 5 Mental Health Myths About Addiction

The quiet struggle often starts in the shadows, a whisper of a different life. For generations, we’ve been conditioned to see addiction through a prism of moral judgment—a failure of willpower, a character flaw, or a deliberate choice. 

This narrative, steeped in shame, shapes how we talk about and how we fail to treat one of the nation's most pervasive health crises. Yet, this story is beginning to yield to a more complex, humane truth: that addiction is not a moral failing but a chronic, treatable medical condition—one inextricably linked with mental health, because addiction does not discriminate.

It impacts people from every socioeconomic background, regardless of wealth, status, or circumstance. It has no regard for the zeros on a paycheck, the degrees on a wall, or the neighborhood someone calls home. The nature of addiction is that it weaves itself into all walks of life—unraveling stability, straining relationships, and dimming futures. It’s an equal-opportunity thief: capable of reaching anyone, anywhere, no matter how untouchable they may seem.

It wasn’t until the mid-20th century that the American Medical Association (AMA) classified alcoholism as a disease, and it wasn’t until 1987 that addiction was considered a disease. According to Indiana University Health, “in 2011, the American Society of Addiction Medicine (ASAM) defined addiction as a chronic brain disorder, not a behavior problem or just the result of making bad choices.”

This profound shift in understanding is not merely academic—it’s a matter of life and death. In 2023, nearly 49 million Americans met the criteria for a substance use disorder (SUD), but a staggering 85% received no treatment.

By confronting these common misconceptions about addiction, we begin to dismantle the very barriers that prevent millions from seeking help, offering not just a path to recovery, but a way back into a community that is finally learning to see them not as a problem to be fixed, but as a person to be healed.

Addiction myth #5: Addiction is a choice.

This is perhaps the most pervasive and damaging myth. The idea that someone with an addiction can simply "stop if they want to" is a fundamental misunderstanding of the disease. While the initial decision to use a substance may be a choice, the brain changes that occur with repeated use are not. Addiction alters the brain’s reward system— affecting decision-making and creating compulsive cravings.

As addiction takes hold, it hijacks the brain's natural response to pleasure, making the substance feel like a necessary part of survival. This neurobiological change makes it incredibly difficult for individuals to quit through willpower alone. 

“Wider access to medical treatment—especially medications for opioid use disorders—as well as encouraging people with substance use disorders to seek treatment are absolutely essential to prevent these still-escalating numbers of deaths,” writes Director of the National Institutes of Health, Nora D. Volkow, for Scientific American. 

Addiction myth #4: People with addiction have to hit “rock bottom” to get better.

The idea of "rock bottom" is a popular narrative in movies and television, but it’s a dangerous concept that can delay vital treatment. This myth suggests that individuals must lose everything—their job, their family, their home—before they can be motivated to change. In reality, waiting for a crisis can have deadly consequences.

Early intervention is crucial for a successful recovery. According to the most recent Surgeon Generals Opioid Use Spotlight, “effective identification, intervention, and integration of prevention, treatment, and recovery services across health care systems is key to addressing substance misuse and its consequences, and it represents the most promising way to improve access to and quality of treatment.” The earlier an individual receives help, the better their chances of avoiding severe health, legal, and social consequences. The truth is, "rock bottom" is a different point for everyone. 

Iron Man star Robert Downey Jr., who has been open about his struggles with addiction, famously said, “Remember that just because you hit bottom doesn't mean you have to stay there.” For some, it might be the realization that their mental health is suffering. For others, it might be the fear of losing a job or a relationship. The most important thing is to seek help as soon as the need is recognized.

Addiction myth #3: Addiction only affects people with weak willpower or moral flaws.

This harmful stereotype perpetuates shame and prevents people from seeking help. Addiction does not discriminate. It affects individuals from all walks of life—regardless of their background, socioeconomic status, or personal character.

The roots of addiction are complex and can be influenced by a combination of factors, including genetics, environment, and co-occurring mental health issues. Many individuals use substances to self-medicate symptoms of an underlying mental health condition like depression, anxiety, or post-traumatic stress disorder (PTSD). 

According to the National Institute on Drug Abuse, nearly 45% of persons who have a substance abuse disorder also experience mental illness. Substance use disorder is oftentimes a comorbidity, making it a health issue that requires care, not a character flaw that deserves judgment.

Addiction myth #2: Opioid addiction is just like other drug addictions.

While all addictions share some common neurological pathways, the insidious nature of opioid addiction sets it apart. The reason lies in how opioids hijack the brain's natural reward system. 

Unlike many other drugs, opioids directly mimic and overwhelm the body’s natural painkillers—endorphins. This creates an immediate, intense sense of euphoria and wellbeing. The devastating twist is that with repeated use, the brain stops producing its own endorphins, becoming entirely dependent on the drug to feel "normal." This isn't just a psychological craving. It's a physical dependence that drives an unrelenting need for the substance to avoid severe withdrawal symptoms.

We can’t talk about opioids without talking about the opioid epidemic. According to the Centers for Disease Control and Prevention (CDC), “from 1999-2023, approximately 806,000 people died from an opioid overdose. This includes overdose deaths involving prescription and illegal opioids.” 

The relationship between opioid addiction and mental health is particularly strong. People with a history of depression, anxiety, or PTSD are at a higher risk of developing an opioid use disorder. The use of opioids can also worsen existing mental health symptoms or even cause new ones. This deep, intertwined connection between physical dependence and mental health makes opioid use disorder especially difficult to overcome.

Addiction myth #1: Relapse means treatment has failed.

One of the biggest misconceptions about addiction is that recovery is a one-and-done deal. But the truth is that recovery is not a linear process. For many, it involves setbacks and challenges along the way. A relapse is not a sign of failure but a common part of a chronic illness. It can be a signal that a person's treatment plan needs to be adjusted or that they need additional support.

Thinking of a relapse as a sign of failure can be incredibly discouraging and can make a person feel hopeless. Instead, it’s important to see it as a moment to learn and re-engage with the recovery process. 

People struggling with substance use disorder deserve help

For all the talk of addiction as a moral failing or a lack of willpower, the most effective treatments tell a different story. They address the root causes, the trauma, the undiagnosed anxiety, or the deep depression that often fuels substance use. It's a journey that doesn't have to be walked alone.

Seeking help is not a sign of weakness, but an act of self-love. Working with a mental health provider like a therapist can be a profound step in the healing journey. It's the most courageous step one can take toward building a healthier, more fulfilling life. By challenging the myths and dismantling the stigma, we can create a world where seeking support is met not with judgment, but with empathy and understanding. There is a path forward, and it begins with that first step.